NPIMap

Organization Active NPI

Women's Contemporary Health Center, PLLC

  • Specialist
  • Fort Myers, FL
National Provider Identifier
1306097829
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0045181 Issued in FL
Legal business name
WOMEN'S CONTEMPORARY HEALTH CENTER, PLLC
Practice address
6150 Diamond Centre CT
Building 400
Fort Myers, FL 33912-4365
Phone
(239) 561-9191
Fax
(239) 561-9188
NPI assigned
Oct 2, 2008
Last updated
Jan 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eileen M Kozak
Title
Practice Manager
Phone
(239) 561-9191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0045181 FL Primary

Addresses

Primary practice location

6150 Diamond Centre CT
Building 400
Fort Myers, FL 33912-4365

Mailing address

6150 Diamond Centre CT
Building 400
Fort Myers, FL 33912-4365
Phone (239) 561-9191

Other identifiers 1

IdentifierTypeStateIssuer
041920600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060418000580 FL Part B Supplier - Clinic/Group Practice 5294744371 Receives reassigned benefits from 13 practitioners
Practice locations: Fort Myers, FL; Naples, FL

National Provider Directory

National Provider Directory

Locations

6150 Diamond Centre Ct
Bldg 400
Fort Myers, FL 33912
Phone (239) 333-0828

6150 Diamond Centre Ct
Unit 203
Fort Myers, FL 33912
Phone (239) 482-3154

6150 Diamond Centre Ct
Unit 400
Fort Myers, FL 33912
Phone (239) 333-3345

1213 Piper Blvd
Ste 203
Naples, FL 34110
Phone (239) 561-9191

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325721600000",
    "number": "1306097829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 DIAMOND CENTRE CT",
            "address_2": "BUILDING 400",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124365",
            "telephone_number": "239-561-9191",
            "fax_number": "239-561-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 DIAMOND CENTRE CT",
            "address_2": "BUILDING 400",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124365",
            "telephone_number": "239-561-9191",
            "fax_number": "239-561-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMEN'S CONTEMPORARY HEALTH CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2012-01-05",
        "status": "A",
        "authorized_official_last_name": "KOZAK",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "239-561-9191"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0045181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041920600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.